Skin Imaging to Inform Laser Treatments
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| ClinicalTrials.gov Identifier: NCT04336163 |
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Recruitment Status :
Terminated
(All 55 subjects enrolled in the study completed the initial study procedures, but due to the pandemic and the prolonged period where we were unable to follow up patients, we were not able to complete the aims for this protocol.)
First Posted : April 7, 2020
Last Update Posted : July 25, 2022
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| Condition or disease | Intervention/treatment | Phase |
|---|---|---|
| Port-Wine Stain Rosacea Telangiectasia Angioma | Device: Optical Coherence Tomography | Not Applicable |
The purpose of this research is to assist laser treatment of skin conditions by imaging the skin to obtain information about lesional skin. This is a pilot study that will explore the utility of skin imaging in guiding the laser treatment of skin lesions. This study will utilize Optical Coherence Tomography (OCT). Data acquisition of the skin will guide laser treatment by providing information on skin lesion characteristics.
There have been shown to be many applications for OCT. This imaging modality has been used to examine normal skin, burn scars, hemangiomas, nevus flammeus, fibrosarcomas, rosacea, and telangiectasias. Skin conditions to be studied include vascular lesions, scars, and inflammatory conditions. Normal and lesional skin will be assessed.
Currently, laser settings are selected without the assistance of imaging. Imaging with OCT provides more information about the characteristics of the skin lesion (such as lesion depth, depth of the most superficial part of the lesion, and the size and density of blood vessels), which could allow for more informed selection of laser settings to treat individual skin lesions. OCT has been used to examine laser treatments as well, but the proposed protocol would include the use of OCT to examine the stated skin lesions above before and after laser treatment in order to compare to historical/prospective controls that did not undergo OCT imaging. The goal of this study is to optimize laser treatment with the assistance of OCT and guide future laser treatments.
OCT is an imaging modality that uses light to image turbid media such as living tissues, and has been successfully used to generate high resolution (~10 micron) cross-sectional images of tissue microstructure in the human retina, skin, gastrointestinal tract, and genitourinary tract. OCT systems are now commercially available for ophthalmic and dermatologic use, and there are several clinical reports on the use of OCT in the vascular system and aero digestive tract, Ophthalmology, Pleural disorder, Neural tissue, Aneurysm healing, and Oral Pathology. This device focuses low power non-laser broad band infrared light onto tissue and does not involve input of significant amounts of energy into the subject; no temperature rise occurs. Because the wavelength of light used for imaging does not have adverse tissue effects, there is no risk.
Imaging with OCT provides information about the characteristics of the skin lesion (such as lesion depth, depth of the most superficial part of the lesion, and the size and density of blood vessels). OCT poses no known risks to the patients.
A multitude of studies have been conducted that validate the utility of OCT in imaging many types of skin lesions. Vascular lesions formulate a good portion of skin diseases studied by OCT, which includes rosacea, port-wine stain, hemangiomas, fibrosarcomas, cherry angiomas, and telangiectasias. Other studies have examined imaging of burn scars, the micro-circulation of the skin, and vascular changes with topical medical application. In all of these studies, OCT imaging aided treatment as well as provided a method to assess treatment outcome.
For port-wine stains, OCT has provided information such as vessel diameter and depth, which was discovered to be quite variable in port-wine stains, indicating that tailored laser treatments are likely to improve result. Byers et al. noted that OCT was a robust and non-invasive method for observing longitudinal dynamics of the subcutaneous microcirculation of tumors. Telangiectasias are a prominent feature of rosacea, and OCT has elucidated information about their treatment with intense-pulsed light to simply examine the effect of the treatment on the targeted lesions.
| Study Type : | Interventional (Clinical Trial) |
| Actual Enrollment : | 55 participants |
| Allocation: | Non-Randomized |
| Intervention Model: | Parallel Assignment |
| Intervention Model Description: | A prospective study on the impact of Optical Coherence Tomography in laser treatment of vascular skin conditions. |
| Masking: | Single (Care Provider) |
| Masking Description: | For the control group, the laser surgeon would be unaware of OCT measurements of patients in the control group and would need to rely on his/her experience and intuition to determine the laser settings to treat the patient. For the experimental group, the laser surgeon will be exposed to the OCT measurements. |
| Primary Purpose: | Treatment |
| Official Title: | Skin Imaging to Inform Laser Treatments |
| Actual Study Start Date : | September 20, 2019 |
| Actual Primary Completion Date : | July 8, 2022 |
| Actual Study Completion Date : | July 8, 2022 |
| Arm | Intervention/treatment |
|---|---|
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Experimental: Prospective Study Group
For the experimental group, the laser surgeon will be exposed to the OCT measurements and will select laser settings and determine treatment parameters based on the measurements.
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Device: Optical Coherence Tomography
Skin imaging to determine vascular characteristics such as plexus depth, vessel diameter, and vessel density. |
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Prospective Control Group
For the control group, the laser surgeon will not be exposed to the OCT measurements and will select laser settings and determine treatment parameters based on standard of care, intuition, and experience.
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Device: Optical Coherence Tomography
Skin imaging to determine vascular characteristics such as plexus depth, vessel diameter, and vessel density. |
- Assessment of change in photographed lesion [ Time Frame: Through study completion; average of one year ]Primary outcome variable includes assessment of change in photographed lesion. Two board-certified dermatologists will grade the degree of change of the photographed lesion in quartiles (no change or darkening=0-25, mild lightening=26-50, good lightening=51-75, excellent lightening=76-95, complete resolution=96-100).
- Number of participants with scarring, blistering, bruising, and scabbing [ Time Frame: Through study completion; average of one year ]Any adverse effects of treatment such as scarring, blistering, bruising, and scabbing.
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
| Ages Eligible for Study: | 4 Years and older (Child, Adult, Older Adult) |
| Sexes Eligible for Study: | All |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria
Subjects must meet the following inclusion criteria:
- Ability to understand and carry out subject instructions or be represented by a legally authorized guardian or representative.
- Ages 4 and older. Patients younger than 4 may have difficulty cooperating with the OCT measurements because each measurement requires the patient to remain still for approximately 30 seconds.
- Seeks and is scheduled for laser treatment of a skin lesion. Exclusion Criteria
Any of the following will exclude participation in the study:
- Inability to understand and/or carry out subject instructions.
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04336163
| United States, California | |
| University of California, Irvine | |
| Irvine, California, United States, 92617 | |
| Principal Investigator: | Kristen M Kelly, MD | University of California, Irvine |
| Responsible Party: | Kristen Kelly, Professor of Dermatology, University of California, Irvine |
| ClinicalTrials.gov Identifier: | NCT04336163 |
| Other Study ID Numbers: |
20195222 |
| First Posted: | April 7, 2020 Key Record Dates |
| Last Update Posted: | July 25, 2022 |
| Last Verified: | July 2022 |
| Individual Participant Data (IPD) Sharing Statement: | |
| Plan to Share IPD: | No |
| Plan Description: | All co-researchers and research personnel only on this IRB protocol will have access to IPD. |
| Studies a U.S. FDA-regulated Drug Product: | No |
| Studies a U.S. FDA-regulated Device Product: | Yes |
| Product Manufactured in and Exported from the U.S.: | Yes |
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Optical Coherence Tomography Pulsed Dye Laser Port-Wine Stain |
Rosacea Telangiectasia Angioma |
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Hemangioma, Capillary Hemangioma Telangiectasis Port-Wine Stain Rosacea Skin Diseases Vascular Diseases |
Cardiovascular Diseases Skin Abnormalities Congenital Abnormalities Neoplasms, Vascular Tissue Neoplasms by Histologic Type Neoplasms |